Cilostazol and Miconazole: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cilostazol
Miconazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased cilostazol exposure
Interaction Deep Dive
Cilostazol exposure is increased with concomitant administration of strong or moderate CYP3A4 inhibitors. The AUC of cilostazol was increased by 117% with concomitant administration of ketoconazole. When coadministration is required, consider reducing the cilostazol dose to 50 mg twice daily1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of cilostazol
Literature reports
3 reports — tap to read
a) Coadministration of ketoconazole 400 mg and cilostazol 100 mg increased cilostazol AUC by 117% and Cmax by 94% 1.
b) Coadministration of erythromycin and cilostazol increased cilostazol AUC by 72% and Cmax by 47%, and increased the AUC of the 4`-trans-hydroxy-cilostazol metabolite by 141% 1.
c) Coadministration of dilTIAZem and cilostazol increased cilostazol AUC by roughly 40% and Cmax by roughly 30%, and decreased the clearance of cilostazol by roughly 30% 1.
Common questions
Can I take Cilostazol and Miconazole together?
Increased cilostazol exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cilostazol and Miconazole interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Cilostazol or Miconazole need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: PLETAL(R) oral tablets, cilostazol oral tablets. Otsuka America Pharmaceutical, Inc. (per FDA), Rockville, MD, 2015. DailyMed
Keep reading about Cilostazol
Keep reading about Miconazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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